Tylenol 3 vs. Codeine.. Which medication do you administer first?

[solumedrol]

Pt. complains of pain. Rates pain at 3 out of 5. Pt. prn pain medications orders are Tylenol 3 and Codeine. Which medication do you administer first, Tylenol 3 or Codeine? Or do you administer both? And what's the rationale behind it?

[Larry77, RN]

narcoticjunkie said:

Pt. complains of pain. Rates pain at 3 out of 5. Pt. PRN pain medications orders are Tylenol 3 and Codeine. Which medication do you administer first, Tylenol 3 or Codeine? Or do you administer both? And what's the rationale behind it?

Tylenol 3 has codeine in it...are you sure they have T3's and plain codeine ordered? If so I would use a scale method if the pain scale is 6 use codeine or something like that--would just depend on how the order is written (might require some clarification from the doc, maybe they are ordered by two different docs).

[Spidey's mom, ADN, BSN, RN]

T-3 and T-4 ARE Tylenol and Codeine together.

Can you clarify?

steph

[solumedrol]

Larry77 said:

Tylenol 3 has codeine in it...are you sure they have T3's and plain codeine ordered? If so I would use a scale method if the pain scale is 6 use codeine or something like that--would just depend on how the order is written (might require some clarification from the doc, maybe they are ordered by two different docs).

Oh sorry. The order was:

Tylenol 325mg PO PRN

Codeine 20mg PO PRN

I can't give them together? or Can I?

[solumedrol]

stevielynn said:

T-3 and T-4 ARE Tylenol and Codeine together.

Can you clarify?

steph

Hi Steph,

The order was:

Tylenol 325mg PO PRN

Codeine 20mg PO PRN

I can't give them together? Or can I?

Thanks,

Rey

[traumaRUs, MSN, APRN]

Yes, you can give both together. Good luck.

[mamason]

The only time I've ever administered codeine, it was added to a medication. Like Tylenol w/ codeine or a cough syrup w/ codeine etc. Could it be that the order was mis written. Say...maybe..

Tylenol 325mg PO PRN for temp or pain

Tylenol w/ codeine (Tylenol #3 or #4) PO PRN for Pain?

If that is what was meant then, I would clarify the order with the MD. I would administer the medication depending on the type of pain. If it was a headache, then, my suggestion to the pt would be Tylenol 325MG. If the pt had pain related to surgery, arthritis, FX,etc. then I would suggest the Tylenol w/ codeine. I would also find out what the pt does at home for pain management if it is a chronic condition such as arthritis etc. I would gauge my suggestions to what the pt does to mange their pain at home.

[mamason]

traumaRUs said:

Yes, you can give both together. Good luck.

SO...is there such a thing as Codeine being administered alone? I've never given it in such a way. Please fill me in. I'm very interested in this this.

[traumaRUs, MSN, APRN]

Yes, codiene comes by itself, usually as a liquid. In the ER, we would give codiene elixir - which comes in doses of 15, 30, 60mg. The elixir dose we had in the ER was 15mg/5cc.

We would use it with kids with fractures (many times the parents had given tylenol at home prior to coming to the ER).

Codiene elixir is also used for coughing.

[mamason]

traumaRUs said:

Yes, codiene comes by itself, usually as a liquid. In the ER, we would give codiene elixir - which comes in doses of 15, 30, 60mg. The elixir dose we had in the ER was 15mg/5cc.

We would use it with kids with fractures (many times the parents had given tylenol at home prior to coming to the ER).

Codiene elixir is also used for coughing.

Thanks for the clarification. I wasn't familiar with it being used alone. Makes sense w/ the children. Is it commonly used for adults?

[PANurseRN1]

mamason said:

SO...is there such a thing as Codeine being administered alone? I've never given it in such a way. Please fill me in. I'm very interested in this this.

Yes, and weirdly enough, when it is not combined with acetaminophen/ASA, it becomes as Schedule II narcotic, not a Schedule III as it is in combo with other meds.

[traumaRUs, MSN, APRN]

Yep - as cough suppresant.